The NEXT Adolescent Health Study is a 7-year longitudinal study that examines a nationally representative cohort of 2,785 high school grade students recruited in the 10th grade during the 2009-2010 school year. Eighty-one schools participated and an oversample of African-American students was obtained. Participants completed surveys in-school during the first year, primarily online in subsequent years, focusing on substance use, physical activity, diet, driving, developmental status, health status, and health care. During the first three years, observed measures of height, weight and waist circumference were obtained. Geocodes of school (Wave 1) and home addresses (Waves 1 and 4) are linked with other databases to provide neighborhood information. A school administrator survey completed in the first year of the study provides information about school environment, programs, and policies. Retention in the study has been excellent, with approximately 82% of those assessed in Wave 1 providing data at Wave 5. Wave 6 data is currently being collected. Students were assessed from all 9 Census Divisions, and come from 22 states. The sample is comprised of 55% (weighted, and hereafter) females, 45% males; and 56% white participants, 20% African American participants, 19% Hispanic participants, and 5% of other races/ethnicities. Wave 4 was accessed the first year post high school, a year marked by many transitions. The majority of participants reported attending a college/university (44%) or technical school/community college (29%). Over half remained in their parents home (56%) with 28% reporting living on a college campus, and 16% living in their own residence (e.g. rented room, apartment). About 50% were not working, 34% work less than 30 hours and 15% work 30 hours or more. Data from the first 4 waves of the study on alcohol use, physical activity, dieting behaviors, and body mass index (BMI,kg/m2) have been analyzed. The percentages of those reporting any alcohol use and heavy episodic drinking showed sharp increases from Wave 1 (36% and 27% respectively) to Wave 4 (53% and 41%, respectively). Over that same period, self-reported physical activity the declined, with 55% of participants in Wave 1 and 36% of participants in Wave 4 participants reported meeting the recommended 60/day on at least 5 days a week. Regarding dietary behaviors, fruit and vegetable intake (times/day) trended downward, from an average 3.95 at Wave 1 to 3.41 at Wave 4. BMI trended upwards, from an average of 23.74 at Wave 1 to 25.27 at Wave 4. Note, for those 18 years and older, BMIs within 18.5 to 24.9 are considered within a normal weight range. In other analyses we found the following: driving while drunk (DWI) or drugged was higher among whites, while riding with an intoxicated driver was higher among Hispanics; previous DWI, drinking, and social norms were prospectively associated with DWI; less sleep was associated with smoking; drinking and binge drinking was greater among those attending 4 year colleges and predicted by previous drinking and social norms; blackouts were common among emerging adults, particularly those attending college and were associated with problems related to social relationships, school, work, and the law.